Paediatric Opthalmology Flashcards
What is amblyopia?
Reduced vision in one eye die to a degraded retinal image throughout childhood. This results in poor development of binocular visual pathways.
List three things that can cause amblyopia?
Squint
Refractive errors
Obstruction to visual axis such as cataracts and ptosis
How can amblyopia be treated/avoided?
Occlusion treatment to good eye
List 5things that can cause a squint?
- Congenital
- Long sightedness
- Cranial nerve palsies (III, IV, VI)
- Muscle pathology such as myasthenia gravis
- Blow out fractures to the orbit
How does hypermetropia result in an esotropic squint?
- It increases the accomodative effort for looking at near things resulting in overaccommodation and overconvergence
How do you treat a esotropia causes by hypermetropia?
Correct glasses as this reduces the accomodative drive, aligns the eyes and restores binocular vision
What is the treatment of a squint?
Correct refractive errors
Treat ambylyopia
Surgery
What would be the indications for performing surgery for a squint?
Large infantile squint
Significant residual squint
Chance of restoring binocular vision
What would you be worried about if a child had an opacity in the red reflex?
Cataracts
What would you be worried about if a child had no red reflex?
Retinoblastoma /retinal detachment
What are the two causes of sticky red eyes in infancy and how do they present?
- Chlamydial Conjunctivitis (Sticky and red in the first 10 days of birth)
- Blocked nasolacrimal duct (Sticky and white uninflamed eye from 2 months)
How do you treate chlamydial conjunctivitis in an infant?
Erythromycin
How do you diagnose congenital nasolacrimal duct block?
Delayed fluroscin dye disappearance
How do you treat congenital nasolacrimal duct block?
Bathe and massage sac
Syringe and probing if no resolving
Most resolve spntaneously by 1 year
